Medicare Benefits Schedule - Item 880

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Case Conferences

MULTIDISCIPLINARY CASE CONFERENCE - MEDICAL PRACTITIONER (OTHER THAN A SPECIALIST OR CONSULTANT PHYSICIAN)


These services are for patients who:

    (a)     have at least one medical condition that:

         i.      has been (or is likely to be) present for at least six months; or

         ii.      is terminal; and

    (b)     require ongoing care from a multidisciplinary case conference team which includes:

         i.     a medical practitioner; and

         ii.     at least two other members, each of whom provides a different kind of care or service to the patient and is not a family carer of the patient, and one of whom may be another medical practitioner.


For the purposes of items 735-758, a multidisciplinary case conference is a process by which a multidisciplinary case conference team:

    (a)     discusses a patient’s history; and

    (b)     identifies the patient’s multidisciplinary care needs; and

    (c)     identifies outcomes to be achieved by members of the case conference team giving care and service to the patient; and

    (d)     identifies tasks that need to be undertaken to achieve these outcomes, and allocates those tasks to members of the case conference team; and

    (e)     assesses whether previously identified outcomes (if any) have been achieved.


Participation in a multidisciplinary case conference must be at the request of the person who organises and coordinates the conference.

Category 1 - PROFESSIONAL ATTENDANCES

880

880 - Additional Information

Item Start Date:
01-May-2006
Description Start Date:
01-Sep-2015
Schedule Fee Start Date:
01-Nov-2012

Group
A15 - GP Management Plans, Team Care Arrangements, Multidisciplinary Care Plans
Subgroup
2 - Case Conferences

Attendance by a specialist, or consultant physician, in the practice of his or her specialty of geriatric or rehabilitation medicine, as a member of a case conference team, to coordinate a case conference of at least 10 minutes but less than 30 minutes-for any particular patient, one attendance only in a 7 day period (other than attendance on the same day as an attendance for which item 832, 834, 835, 837 or 838 was applicable in relation to the patient) (H)

Fee: $48.65 Benefit: 75% = $36.50

(See para AN.0.63 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $145.95


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.63

Case Conference by Consultant Physicians in Geriatric/Rehabilitation Medicine - (Item 880)

Item 880 applies only to a service provided by a consultant physician or a specialist in the specialty of Geriatric or Rehabilitation Medicine who has completed the additional requirements of the Royal Australasian College of Physicians for recognition in the subspecialty of geriatric medicine or rehabilitation medicine. The service must be in relation to an admitted patient in a hospital (not including a patient in a residential aged care facility) who is receiving one of the following types of specialist care:

· geriatric evaluation and management (GEM), in which the clinical intent is to maximise health status and/or optimise the living arrangements for a patient with multidimensional medical conditions with disabilities and psychosocial problems, who is usually (but not always) an older patient; or

· rehabilitation care, in which the clinical intent is to improve the functional status of a patient with an impairment or disability.

 

Both types of care are evidenced by multi-disciplinary management and regular assessments against a plan with negotiated goals and indicative time-frames. A case conference is usually held on each patient once a week throughout the patient's admission, usually as part of a regular scheduled team meeting, at which all the inpatients under the consultant physician's care are discussed in sequence.

The specific responsibilities of the coordinating consultant physician or specialist are defined as:

  • coordinating and facilitating the multidisciplinary team meeting;
  • resolving any disagreement or conflict so that management consensus can be achieved;
  • clarifying responsibilities; and
  • ensuring that the input of participants and the outcome of the case conference is appropriately recorded.

The multidisciplinary team participating in the case conference must include a minimum of three formal inpatient care providers from different disciplines, including at least two providers from different allied health disciplines (listed at dot point 2 of A24.7). The consultant physician or specialist is counted toward the minimum of three.  Although they may attend the case conference, neither the patient nor his or her informal carer, or any other medical practitioner can be counted toward the minimum of three.

The case conference must be arranged in advance, within a time frame that allows for all the participants to attend.  The minimum of three formal inpatient care providers must be present for the whole of the case conference.

Prior informed consent must be obtained from the patient, or the patient's agent including informing the patient that he or she will incur a charge for the service for which a Medicare rebate will be payable.

Item 880 is not payable more than once a week or on the same day as a claim for any of the physician discharge case conferencing items 830, 832, 834, 835, 837 and 838, in respect of a particular patient.

Related Items: 880


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change